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Maryland's proposal includes a requirement for local voting changes to receive preapproval, mirroring core provisions of the federal law that was struck down by the Supreme Court a decade ago.
The paper explains the FDA doesn't require a preapproval inspection of plants that make OTC medicines, and the FDA conducted just 684 overseas inspections in 2022; it has some 4,000 foreign facilities to inspect, and about 1 in 5 are in India.
Source: https://www.newser.com/story/333510/eye-drops-recall-deaths-blindness-now-an-fda-inspection.html